Postoperdive recovery response in pediatric patients: comparison of inhalation anesthesia with isoflurane and infusion anesthesia with ketamin

OBJECTIVE: We compared Ketamin infusion and Isoflurane inhalation usage in anaesthesia maintenance with respect to postoperative recovery criteria in pediatric patients.
STUDY DESIGN: According to approval of the Ethical Committee, 30 children (<12ys) of ASA I-II were rabdomly assigned in two groups. Patients were premedicated with intranasal 0.2-0.3 mg/kg Midazolam 30 minutes before operation. While Ketamin infusion 50-80 ug/kg with 0.15 mg/kg intravenously Midazolam addition every 30 minutes were given to first group, Isoflurane inhalation 0.5-1 % with 1 mg/kg IV Meperidine addition were given until 5 minutes before the end of the operation to the second group. Postoperative recovery of the patients was scored according to the Ramsay Sedation Scoring. Unpaired t test, Tukey Kramer Multipl Comparisons Test were used for the statistical analysis.
RESULTS: There were no significant difference between the two groups for the age, weight, operation and anaesthesia duration (p>0.05). In both groups, recovery criterias were significantly high in postoperative 20^ minutes compared to the postoperative 1stminutes. But no significant difference was found with respect to recovery time and quality.
CONCLUSION: We concluded that, either Ketamin infusion or Isoflurane inhalation on equally effective regiments with the aspect of postoperative recovery criteria in pediatric anaesthesia.

Çocuk Hastada Postoperatif Derlenme Kriterleri: Isoflurane ile Ýnhalasyon Anestezisi ve Ketamin + Midazolam ile Ýnfüzyon Anestezisinin Karþýlaþtýrýlmasý

AMAÇ: Çocukta anestezi idamesinde Ketamin infüzyonu ve Isoflurane inhalasyonunun postoperatif derlenme kriterleri üzerine etkilerini karþýlaþtýrdýk.
MATERYAL ve METOD: Etik komite izni alýnarak ASA I- II grubunda 12 yaþ ve altý 30 olgu rastgele iki gruba ayrýldý. Operasyon 30 dakika önce vakalara intranazal 0.2-0.3 mg/kg Midazolam ile premedikasyon uygulandý. Grup I‘e her 30 dakikada bir intravenöz (IV) 0.15 mg/kg Midazolam ilavesiyle 50-80 ug/kgldak Ketamin infüzyonu, grup 2‘ye IV 1 mg/kg Meperidin ilavesi ile % 0.5-1 Isoflurane inhalasyonu operasyon bitimine 5 dakika kalana dek uygulandý. Olgularýn postoperatif derlenmesi Ramsay Sedasyon Skoruna göre puanlandýrýldý ve istatistiksel unpaired t-testi, Tukey Kramer Muit ipi Comparisons Test ile sonuçlar deðerlendirildi (p<0.05 ise anlamlý).
BULGULAR: Yaþ, aðýrlýk, operasyon ve anestezi süreleri açýsýndan gruplar benzerdi (p>0.05). Her iki gruptada postoperatif 20. Dakikada uyanma kriterleril. dakikaya göre anlamlý olarak yüksekti. Gruplar arasýnda postoperatif derlenme süresi ve kalitesi açýsýndan anlamlý farklýlýk yoktu (p>0.05).
SONUÇ: Pediatrik anestezide postoperatif derlenme kriterleri açýsýndan Ketamin infüzyonu ve Isoflurane inhalasy onunun alternatif olduklarýný düþünüyoruz.